Friday June12th Final Day of Surgery…can’t believe the week is over!

We started the day with our team photo in front of the hotel then headed to the hospital. We typically have a “lighter” surgery schedule on Fridays because we have to pack up everything & that was the case here as well. They did want to “add on” a 7 month old little boy but he had a fever & cold so we couldn’t do surgery & he will have to wait until the next mission – but he is well nourished & doing okay so it’s ok.  We had 10 patients on the schedule (as opposed to our usual 22 or so).

The first 3 cases off all 3 tables were all boys between the ages of 1 & 2 years & I had 3 pairs of biys shorts left so they all got new shorts – I just LOVE IT when that works out J Amar was one little boy with such sweet parents. They both just put their heads almost down in the bed with his to get a look at his new lip…I did snap a few photos! Musa was another little one that Julie took care of & we got pics of him with his shorts too & Yenus was the last one – they will be some of the best dressed toddlers in Ethiopia thanks to Carole!

We have had a local nurse Wubit who is not yet credentialed by Op Smile but is a fabulouse nurse & has come as a volunteer everyday – I gave her my extra stethoscope today because here they have stethescopes in the hospital to use on the patients but very few of the nurses have their own. Annemeike gave her a pen light too – she was so delighted! Emu was also helping us –she is a Junior in college & a public health student she was our translator so I gave her a disposable stethoscope I brought.
The 10 year old son of the Sudanese woman had surgery today – so happy for both of them to return to their  home – even if it is a refugee camp with new opportunities. One of our patients had a problem with his intubation so he stayed a little longer with us & got a few breathing treatments then was good as new! One of our last patients was an older man from the Masai tribe – we saw lots of those folks when I was up in Mekele but not so many here in Addis.  We also did an older woman today – she said she was 55 butmost people here don’t know their real age – she looked older not sure if it is the hard life they live or what. Also some of the “older people” have orange henna dyed hair – a new way to cover grey?
I saw Berket again my friend with the burns cause he stopped me to thank me & showed me his new dressing on his leg with the supplies I got him. I found out a little more about him – he is actually 16 & was burned in an electrical fire at his work. He doesn’t have a dad just him & his mom & he was supporting them. I asked Wubit why he was in the hospital & she said just for the dressing changes? But all they would normally do is pull off old gauze & put on new gauze which is so painful. I am so glad I was able to get him supplies & had Wubit ask if he needed anything else & we were able to do a little more to help them & I took a photo of him & his mom – I wanted to remember them…they were such sweet people despite their dire circumstances according to our lives & expectations. I think the one lesson I have learned is the resilience of these people.  NO matter what their lot in life, their challenges healthwise, with food, shelter, water all the basics – they get up again & again. They don’t complain that life is too hard, they don’t expect people to “fix” their problems they fall down again & again & always get back up.
Molly has gotten us croissants – regular & chocolate from a French bakery here (yes that makes no sense to me that there is a French bakery in Ethiopia but there is) & also from a bakery at the Sheraton in Addis (also another thing that doesn’t fit in is a 5 star $500 a night hotel). Anyway I am pretty sure I have eaten more croissants in the past 5 days than I have in the past year…so much for usually losing a few pounds in Ethiopia!!! In the break room they were actually roasting coffee beans over an electric coils…then grinding them & making coffee. I am not a coffee drinker but I am guessing they could give Starbucks some competition!
We got things packed up fairly quickly then headed to “the market by the post office” yep that is the description & directions…as we were walking there the sky opened & it started pouring rain..which has happened few afternoons but we were in the hospital the other days . We got SOAKED!!! June starts the “rainy season” here = no kidding!
I have realized that after 9 missions I have become unphased by some things…like cockroaches in the hospital or hotel room, that there are a lot of sinks in places but 90% of them do not have running water, the electricity going out intermittently is “normal”, I have learned to be a “McGyver” with supplies that we have & supplies that we need, as comfortable as we get in a setting we need to remember that some of these people are desperate & things “disappear” if left unattended.
The missionaries came back this afternoon to help us pack up & carried 120 lb trunks downstairs for us – they were great & tonight was the team party at an Ethiopian Cultural center & they missionaries were invited. It was ALL Ethiopian foods – my plate was rather empty but they said it was 5 Star gourmet Ethiopian food & they ate up!  I als brought them all my s\random stuff I usually just leave in my room – extra peanut butter & crackers (that was what made them most excited), my extra toiletries & a few other peoples too for Sis Winchet & her organization, an airport blanket I picked up on my way here  & random other stuff. The Ethiopian dancing I had seen before but it is always very impressive!
We got back to the hotel about 10 to start packing ourselves. A few people left tonight &  while a part of me is always anxious to get back home I am ready to sleep in for a day & just soak in what I can tomorrow before I start my journey home!

Thursday June 11th – Just a Busy 4th Day of surgery & lots of crying babies J

We had a busy day scheduled & there are still team members getting sick!!! Laney was REALLY sick today & basically the team Dr. (Annameike our intensivist in the Recovery Room) told her to stay back. She has the most mission experience in the Pre/Post area & had really been running it efficiently so her not being there causes a bit of a frenzy this morning as she had been organizing everyone for surgery while the other nurses got the prior days surgery patients discharged. Since the PACU isn’t busy in the morning until patients come back after surgery we went out there & tried to help. We created a plan…not sure it was the same as before but within about 30 min we had the 1^st patients for all tables ready to go back to the OR and the 2^nd group organized on a bench outside the OR having their final pre-op check by the pediatrician. Once the first set were all on the OR tables we moved the 2^nd set in to the Child Life area to “play” before surgery then I had the parents waiting for children in surgery on the bench on the left & I stopped anyone(via universal hand language) from sitting on the other bench so we could get the 3^rd set rounded up, armbands on & ready to see the pediatrician. Then I got the #’s for the 4^th & 5^th sets of patients & had the interpreters tell them they didn’t need to all crowd or wait in the hallways – yep it was all about crowd control & getting people where they belonged & after that it ran pretty well – but we did miss Laney!

Annameike has been taking care of all the team members who are sick & this morning took a little rest herself in the PACU before we got patients cause she wasn’t feeling 100% - she even got a little teary about feeling crummy & I could totally relate to that from a mission when I was feeling sick & far away from anyone who could help me feel better. I got her some water & pepto bismol & she was feeling a little better pretty quick.

I did not take many pictures at all today – I was just too busy…and the 1^st 12 patients that came back to us…NONE of them were very happy – our little room was quite loud with LOTs of crying kids!!!

Today I was talking to my new friend Bol (from screening day) he is the one with all the Sudanese people & he keeps track of all of them on the surgery schedule. During screening he brought a  little 10 year old girl  Duot in who had a severely infected leg & fever okus a significan cleft lip. Op Smile was able to get her admitted to the hospital here & get her started on antibiotics & get her wound cleaned. Today Duot was healthy enough to have her lip repaired. She was brought here by Bol & accompanied by her 30 year old sister. Two years ago during the Sudan civil war/unrest their dad was killed by the military. At some point the 2 sisters fled the country & ended up in the refugee camp on the Ethiopian border where they have lived for 2 years in what sounds like are pretty horrific conditions. They believe their mom is in a camp in Sudan but they have had no communication with her for 2 years. Her sister is pregnant & the father of the baby is in the military in the refugee camp? But he has now moved onto a younger girl…their story was heartbreaking in so many ways & on so many levels…BUT here was Bol, taking care of HIS PEOPLE, bringing her here for the hope of a brighter future as far as her lip was concerned. We were able to help with that but the challenges these 2 sisters have is something that none of us can really understand. I loved the tenderness of this older sister caring for her younger sister. I had 2 size large dresses left & gave them both to Duot.

Midway thru the day Becca one of the pre/post nurses brought me the crown they give out everyday & thanked me for “saving pre/post” Really it was a team effort I just led the charge J But I did wear the crown the rest of the day!

One of our third round of patients was Malatu – he was a VERY WELL NOURISHED 2 year old – which is kind of unusual here as many kids are thin but he could have nothing to eat after midnight in preparation for surgery & all morning he was having your standard 2 year old tantrums asking for Injera (the spongy bread stuff they eat) It wasn’t really funny but it was – tantrums cross all cultures I guess. We called him the “Injera Boy” cause that is what he was asking for all day. After surgery he didn’t want juice & they had served Injera at lunch so I went in the lunchroom & got him some….he didn’t eat it right away in recovery but the pre/post nurses said he ate it as soon as he got to his room –so funny!

One of the final round of patients was a 35 year old mom – also in the group from the Sudanese refugee camp. She was having a lip repair today & her 10 year old son will have his repaired tomorrow.  She was another who stared a long time at herself in the mirror appreciating the transformation the surgical team was able to provide her J

One bummer was that Aziza one of the recovery room nurses with me had her Iphone 6  stolen. She had it out taking photos & isn’t sure where she may have left it but in a 30 min window it was gone…just a reality check that we are in a country where people are very desperate & a reminder that we all need to be cautious with our belongings.

We have had 2 male OSI High School students with us on this trip – they are great boys & today they went to an orphanage with Susan their student sponsor. At the orphanage they have 750 kids & moms. It is run by a woman who is trying to help the moms get out of prostitution & abuse on the streets & teach them a trade & the kids are in school. It has become a well funded NGO – I wish I could have gone with them!!!

When we got back to the hotel I face timed Doug at home & intended to shower & blog etc but fell asleep, in my scrubs & when I woke up a few hours later I just showered & went back to bed…so this entry is a bit delayed but boy did I sleep well & must have needed the rest. I can’t believe tomorrow is our last day of surgery…arriving here & all that has occurred in between seems like so long ago. I am tired but it is a good tired..tired because I have given my all to serve these people who live lives I will never understand and have hardships and day to day living I cannot fathom. We offer some hope & help & I only pray they are watched over in this difficult world that they live in – especially these precious children.

Wednesday June 10, Ethiopia Surgery Day #3 - A Great Day with some unusual events

Today was a really great day with a few unusual events….the first was that we in the Recovery Room were ready to leave at the same time as the rest of the team & got to the hotel by 8 pm. That has NEVER happened to me on a mission & it was a very pleasant mid week surprise. That meant we could get back, shower, eat dinner in the hotel & now I have had time to check some emails & blog before it is midnight!!!

When we got to the hospital I went to post op & saw a few of the patients from yesterday – they were looking great! Op Smile has a policy that in order to protect the patients privacy we agree not to post  on social media surgical photos or ones where they are still in the midst of healing but I do have some truly amazing before & after pics I will happily share with any who are interested.

So about 25-30% of the team are not feeling well – some typical travelers diarrhea from eating bad food & others with respiratory infections. AnnaMeikie our team dr is handing out Antibiotics like candy!!! I am feeling just fine thankfully but I rarely eat the food in any country – I will eat some breakfast at the hotel & then its the food I bring - tuna, pnut butter or protein bars and I have only ever gotten a tiny bit sick one day in Bolivia. Truly I have been careful & also blessed. I always think I didn’t travel 10,000 miles to get sick so I am very cautious. I am sure the long days & lack of sleep & weird hotel ventilation without AC etc also plays into everyones health too. As for me I am grateful to be healthy!

Usually my mornings are calm but today was a little busy – I did the schedule board but was missing some patient weights so tried to get those but fidning a scale in a hospital in Ethiopia seemed like I was asking for a million dollars – there wasn’t one to be found here so for one patient we guessetimated until we could retrieve the Op Smile scale from the screening cargo. Also Abdi the little 5 month old from yesterday who had a lip repair but lots of IV access problems got sick overnight so they brought him to us & we gave him a respiratory treatment & started antibiotics. He is really a cutie - so being a pharmacist, repsiratory therapist, admissions clerk & nurse all in one made for a busier than normal morning  

Our first case came back & was another little 5 month old boy with a Cleft Lip. Usually once they are settled we have a volunteer go get one parent to come back & see the baby – this time the dad came in & he was SO HAPPY when he saw his son he literally had the biggest beaming smile & turned around & RAN out to get his wife…then they came back in together  & the dad could not stop smiling – I got a photo of him I posted  - but I’m not sure it captured the pure JOY he was radiating – They were such a cute little family, this was their first baby. I gave them some shorts & socks & took several photos of them. Such a reminder of whay I am here & that parents are parents in any country.... 

We did quite a few older school age kids today, 8-14 year olds & a few had severe bilateral clefts so both sides of their lip were involved & deformed & those repairs really are miraculous – quite a few were boys so I gave them some of the CHOC T-Shirts I brought & also took some before & after pics. We also had a 6 year old girl Deme & her mom was so sweet – I pulled out a dress for her & thru a translator told her my friend and some girls who are 11 years old made these dresses & she couldn’t believe it – she had the greatest smile & when she left the recovery room said to me” love them for me and tell them thank you!” I have a great picture of her & Deme too!

THere was a HUGE thunderstorm in the afternoon that lasted about 30 min...with so many people living outside on the streets or in litle huts made of mud I wondered how that impacted them...day to day challenges we never even think about - or at least I dont.

Since Monday there has been a boy I have seen every day who I guessed was about 14 years old and a hospital patient on the same floor we are on. He obviously had some severe burns & right now his left leg was wrapped in gauze from his ankle to his thigh &he was some days using a cane to help himself walk. I could see thru the gauze where the drainage had dried or was oozing. Each day I saw him & his leg I thought of how awful & painful it would be to remove or change the bandage because the gauze was basically attached on to the burn wounds. I smiled & waved at him each day but in the mornngs I would busy myself with "my stuff to do:" & when I saw him throughout the day he was walking the hallways & I was usually taking a patient to the post op ward. It was really pretty easy to "see him" but not "really see his need". Quite honestly too after getting involved with the little boy on Saturday I was a little “gun shy” to move beyond my planned “mission activities” even though clearly this boys situation was totally different. It is hard to be in this environment where there are so many needs & you know you can’t take care of even a small percentage – it can become overwhelming if you think about it too much or really look at all the poverty, hunger & basic needs that are unmet in so many lives here. But this kid had caught my attention & I knew I needed to do something…so I talked aloud about it with one of the translators cause I wasn’t sure what to do – I honestly didn’t want to volunteer to change the dressing but I knew it needed some attention. The volunteer explained to me that the people have to bring in most of their own medical supplies, food & even bedding when they are in the hospital???? The hospital has limited supplies & if you need them you have to pay for them before you get them. I really don’t understand it? You only get pain medicine if you pay for it with each dose??? I am not sure about otehr medicines or care. I knew what this boy needed was clean water to soak off the old gauze, antibiotic ointment to put on the wounds followed by non adhesive gauze to cover them & then the rolled gauze that he was now using over all of that. I found out there was a “pharmacy store” right by the hospital  where I could get all of that & so when it was slow in the recovery room I went over there with a interpreter, bought all the stuff then pulled the boy into a side room  (& his mom followed – I didn’t know he had a mom there) and explained I had seen him all week smiling & noticed his leg & thought he needed more care. He actually seemed to understand some English but I had the interpreter explain what I thought the process was & what I had gotten him to help his leg heal. It was about $30 US for a large supply that he could probably use for a 3 weeks…he asked some questions about the healing & was so grateful – the mom gave me a huge hug & at the end of the day “Mohammed my new friend”  & I took a picture together that I did post. I was reminded that the small & simple things we do can make a tremendous difference and that when you see a need & then feel prompted to do something about it you should do just that…it only took me 3 days to figure that out!!! I am hoping I will see my friend again tomorrow & Friday as I have the past 3 days & I can be sure he has what he needs to help his leg heal….   

I am told the schedule is “packed tomorrow” so we will have a LONG day…so I better get to bed. I am so grateful to be here - I am not sure if Ethiopia will be in my future anytime again soon so I am trying to "take it all in" and give 200% to do whatever I can do this week to make a difference. If I am going to be away from family & friends I want to be sure this time is used wisely. I continue to learn more about the world & myself each & every day here....  

Tuesday June 9th – 22 more surgeries done – what a wonderful day!

Well I just got back to the hotel & it’s nearly 10:30 pm but I want to blog before bed otherwise one day blends into the next & there are too many great people I have met who have touched my heart here & stories I have heard that I dont want to forget.

I got a great night sleep last night & I felt like a new person when I woke up J  We had a full day ahead of us. Yesterday another 20 or so people came to be screened & we already had a full schedule & some had traveled several days to get here. Op Smile is very aware of that & tries to prioritize patients & work things out. In this instance there is another organization near Addis this week that they are going to refer some patients to & some will wait until the next mission or see a local surgeon who does some individual cases. The mornings are always chaotic for the Pre/post ward with 20 patients who have spent the night after surgery & 20 more there to have surgery all together in 2 rooms with mats on the floors. The Recovery Room is slow until the first cases are done so I try to see where or how I can help. Today I made the “post it schedule” where each patient we will do surgery on is on a post it so everyone has a visual of what is going on where J
This morning I played with Meftea a 7 mos old cutie who has a cleft & facial deformity (I took a picture with her) she was going to have a big surgery & be in the OR for awhile & her mom was nervous. I told her I would be caring for her after.  She was a 2^nd case & finally got back to the recovery room at 1:30 – she had some troubles though with fevers & things so stayed with us until 5:30. Her mom was SO OVERJOYED with the results – the plastic surgeon Malin from Sweden did amazing work.

One of the earlier cases out was Kaleb, he was an 8 mos old boy. His mom was well dressed & spoke some English, she was very soft spoken & expressed gratitude that we came to her country. He was a little chunky boy, very well fed & I gave him some cute shorts & socks. It is interesting to me that even families that seem to have some financial means rely on organizations like OSI to get their child help. The day stayed really busy and Julie & Aziza helped me give out lots of clothes.

I forgot about my “no hydrating policy” & drank 2 botttles of water & ended up “paying to potty”  at a nearby building that is really nice that John Hopkins University built here to offer aid & do research. They said we could go there but the woman who had the key was very inconvenienced that we asked so we “tipped her”. It was truly the best $$ ever spent!!! A nice bathroom with flushing toilets & sinks was almost like the joy of Christmas morning! Seriously….

There was one patient that really disturbed me; a little 1 year old who had a beautiful lip repair done but his head was covered with probably 30 circular burns from cigarettes – in the US that is obvious child abuse but here I was told it was a tribal treatment to get rid of evil spirits? It was really hard for me to handle; I understand it is their culture but I imagined this little guy crying each time he was burned & it just turned my stomach…he was so sweet & cuddly.

There have also been lots of kids coming into surgery with Mohawk haircuts – I wondered if it was a tribal thing too & found out today that it is often done before surgery as the Mohawk is the “handle” for God to hang onto & keep them safe during surgery – now that tradition seemed much better than the evil spirit one!  

Another one of my favorite patients today was 6 year old Matu. Her mom had hid her away in their hut & never let her go out in public most of her life because she had a cleft lip. About 2 years ago a Christian Ethiopian woman who goes out into small villages to help people “found her” in this hut & told the mom about the opportunity for surgery but the mom didn’t believe it could be fixed & thought the woman was going to do something with her daughter. Finally the woman convinced the mom to let her bring her to Addis this week  and possibly get surgery  & today she had a lip repair – an hour surgery that would completely change her life & let her live outside her hut. The mom wasn’t here but when the woman came in she was very tearful because of how great the little girl looked and knowing the change in her life. I gave her a dress that she put on right away – it was pink as were my scrubs today so we did a little photo shoot together!

Since I left at 7:30 last night I stayed for the later cases tonight…most of them were older patients – 2 were 22 year old with VERY LARGE bilateral cleft lips – they were truly transformed by surgery today & it is just amazing to me to think that their lives & how they are seen, accepted & looked at will be totally changed by the one hour of surgery. We also did the 74 year old man – just with local anesthesia…some people thought WHY? But it was a 30 min ”quick fix”. When asked why he had never come before for surgery he said “he never knew he could” so the physician team agreed that if he was brave enough to come now & ask for help at 74 they would do it – HOORAY for him!

We had a surgeon cancel at the last minute due to an emergency  so we have 4 surgery tables & 5-6 patients on each per day. I think our total will be about 90 patients getting surgery.  The needs are always greated than the resources & I have to remind myself it isnt about the #'s it is about the individuals & families.

We did some palate repairs today too – those are more complicated & more painful for the kids but they did pretty well – a couple we kept awhile in recovery so at one point we had 3 who needed to stay for “extra attention”, 3 others & each with a parent so our little 4 bed recovery room was bursting at the seams & very noisy but none of us complained because everywhere we looked we saw joyful families. We may not be able to communicate directly with them in a similar language but seeing how much these moms & dads love their kids is the same worldwide & just having the privilege of being a part of their care is a gift. Tuesday is over & I already know that in the blink of an eye it will be Friday & the week of surgery will be over so I am really taking it all in there are so many sights, sounds, smells, people etc all of which is going into my memory. I really am blessed to be able to be a part of this work & while we are “changing lives one smile at a time” I think I am having my own life changed one mission day at a time on every mission I am a part of…I am a different person than I was 5 years ago when I started doing this – I know this is part of why I became a nurse to use my skills and serve people whether 10 feet or 10,000 miles in my world.

It’s almost midnight & again the wake up call will come soon so GOOD NIGHT from Addis Ababa Ethiopia!

Monday June 8th Surgery Day #1 We made 20 new SMILES!!!

What a GREAT first day of surgeries!!! The first day is always a slow start by the time each area does final set up & each surgical table starts in sequence. The child life area where the patients wait right before their surgery is just outside the Recovery Room so that gives me a chance to go see which patients are going into surgery - we have a schedule but they are just pt numbers, names & ages & I like to see who I remember from screening. One of the first patient today was my "pink princess" - I know I have a pre picture of her but took one this morning too. She was such a cutie & a great way to start my day. I found out she was the 10th daughter in this family...I cannot even imagine!!!! Her mom was so sweet & so grateful. Amram was 5 & I was able to give her one of the cute dresses the girls from church made & some fun disney socks! The next patient was also 5 years old Yasmin - she was one who had traveled 2000km from the Somalia coast - I gave her a cute striped drsss & she wanted to out it on before she left the recovery room. I snapped some photos I will share later.

After lunch Addisu a 1 year old rolled thru the door - I put a photo of her & her mom in my collage today. At the last mission 6 months ago she came & at 6 months of age was morbidly malnourished & weighed 5 lbs. She was not eating with her cleft lip & palate but was too sick & small for surgery. That team admitted her to the hospital & worked with the mom on feeding even suggesting they add a bit of sugar to each feeding. This mission she came back at 1 year of age weighing 10 lbs (still small for her age but basically doubled her weight) & was able to get her bilateral cleft lip repaired - she looked so good & her sweet mom was so HAPPY!!!! She is one of the Op Smile miracles.

Hdami was an 11 year old Muslim girl who also traveled a great distance to get her cleft lip fixed. She was very concerned when she woke up that her head scarf wasn't on properly (I tried!) so I helped her fix it & then also gave her a dress that she immediately put on. We also had quite a few boys today that i gave some socks or shorts to & also some CHOC Walk T-shirts - yes there will be children walking around Ethiopia with CHOC T-shirts on - I think that is AWESOME!
My friend Wendy's daughter had made a little dress all by herself in addition to the ones her class made - I gave it to our tiniest patient today a 4 month old who had her lip repaired. Her mom smiled so big when I told her about Lexi & that she had made it for her little girl.

In the afternoon the cases started coming off a little more regularly & we had a backlog of some that needed more time or treatment in the recovery room - a few that we gave respiratory treatments too & others we just needed to watch a little longer so we had some chaos for a few hours. Later in the evening there was another 10 year old girl Bishara, she too had traveled far with her dad & when she came back she was still very sleepy but we let the dad come in & sit by her bed. He immediately was crying & while that does happen & is very tender to see the love & bond between father & daughter I wasnt prepared & perhaps becuase of my emotions being at the surface I got teary too - he grabbed my hand & told me thru an interpreter these were "happy tears" & said "Thank God and Thanks to all of you for changing my daughters life". I was glad to have some "happy tears" myself. When Bishara woke up & we handed her a mirror to see her new smile she held onto the mirror for a good 5 min & just kept looking at herself - that is also in my photo collage. Then she would put the mirror down for a minute or 2 & pick it up again & stare & smile. I opened her chart & each patient has a "pre surgery photo" & showed it to another nurse & Bishara looked at it and pointed to the picture then to herself & waved her hands saying that picture wasn't her anymore. Her life really was changed by this surgery & we could see that already.

At 7:30 there were still 3 cases to finish but since I am "on call" tonight I was the one to leave in case I get called in tonight (which s very unikely fortunately) I normally would decline leaving early & stay but since I only got anout 4 hours of sleep last night, & not great sleep the night before  I agreed to go & just got home & got showered & wanted to do a quick blog post before going to bed. I am  hoping for 7 hours of sleep tonight!!! We did 20 cases today - all lips  -there are a few palates tomorrow & another full schedule. I am getting "in my groove" & appreciated many moments today & really felt good being busy, connecting with families & hearing their stories & sharing the clothes that I brought with me. Julie & Aziza are the other 2 recovery room nurses & they are great to work with as is the entire team. I am looking forward to a good week & the opportunity to positively change the course of these childrens lives by giving them new smiles.

Heading to bed now...GOOD NIGHT & THANK YOU FOR ALL THE LOVE & SUPPORT!

Sunday June 7th - Team Day & for me a day to regroup

I am putting this here as a placeholder for myself so I can go back & blog about team day & the day I spent reflecting on the night before

Day #3 Part 2 - Remember this blog is for me - this post is hearbreaking - read only if emotionally ok

So 8:30 pm until 3:30 a.m. was a whole separate day & experience that is extremely difficult to accurately & completely capture in words – saying you had to be there to understand it is an understatement.

After Aziza called for help I ran in the room along with Glenn. Annameike was already there & the Ethiopian nurse was somewhat anxiously doing chest compressions. The patient had vomited some old blood, coughed out an oral airway & stopped breathing & dropped his heart rate. Glenn & Annameike took control of the situation. We found & started using our equipment to breathe for the child & his heart rate gradually rose. We weren’t really set up for an Emergency – we had our supplies organized for post op care & a list of the things we would get Monday morning. This wasn’t an Op Smile patient, no one really knew what was going on with the child other than that day he had a shunt placed in his brain for hydrocephalus (which is somewhat common in Ethiopia). All we knew was there was a child with a medical emergency & as pediatric medical providers we needed to intervene. A Code situation is often chaotic & this was no different – but we were all Pediatric Critical Care providers & we all went into action seamlessly. We hand bagged him & immediately got ready to put a breathing tube in. We don’t know why but he had a lot of swelling in his airway so it was a challenging intubation but Glenn got a tube in & we realized we didn’t have a stethoscope in the room to check his breath sounds but quickly got one. As a team we secured his tube while simultaneously securing  his IV, placing an NG tube & giving a variety of medications. I felt like I was constantly putting my head out the door asking Molly or someone for another item we needed & didn't have. We were in constant intervention mode until about 10 pm, & while we were doing everything we could - REMEMBER we are in Ethiopia this is not like an episode of ER or Grays Anatomy – we have no respiratory therapy, no pharmacy access, no ability to get lab tests or blood gases, minimal equipment, no ventilator machine to breathe for him so one person had to do that the entire time and no real information from any reliable medical source regarding his condition or surgery that day as the Ethiopian physicians were not there & while we tried to reach them on the phone that was unsuccessful until several hours into this event. We had given many meds so it was hard to know if he was responsive after all our efforts but we had checked is pupils & they were fixed & dilated – often a sign of severe brain injury so there was a lot of somberness in the room. By then it was probably 10:30pm but I am not sure – most everyone other than the 5 of us directly involved in the care & 4-5 of the Op Smile team leadership  had returned to the hotel – there really wasn’t anything they could do & more people in the room typically just means more chaos & poor communication. I just remember it was about this time I was going to get him cleaned up as they had located the parents & we wanted to bring them in the room. Before we did that I asked for a ”team code review” of all we had done & where  we were & if we all agreed we were stable in a critical situation – which was the case. 

The parents & 2 older brothers came in – they had not even seen him since before surgery & had never met or talked to the surgeon which was completely baffling to me but not unusual for this country.  With Aziza translating we explained to them what had happened & that we were trying to reach the Ethiopian doctors & by then an Ethiopian anesthesiologist & resident had come in & Glenn talked to another doctor at the other hospital on the phone. Somewhere in there Molly asked if we were ok – I said to her "yes but this child may very well die I just want you to know that". I am not sure why I felt the need to say that but since she had a lot of responsibility but hadn’t been in the room I thought she needed to be aware of that. Glenn had also communicated with someone that the child needed an ICU bed which this hospital didn’t have?  And they were working on that. We got a bed at a 4 bed pediatric ICU & knew that if the child was to have any chance of survival we needed to get him there so we also asked for an ambulance & prepared all our supplies for a transport. There was an enormous amount of red tape just to get permission to transfer him. The ambulance arrived & I went down to check it out & see what we would need. It was basically a small white station wagon with a stretcher in it – no oxygen, no suction, no place to put an IV, no monitor of course & no equipment & not even a sheet on the gurney which was ground level only did not raise up. I got to go give the team that report….so we needed to take everything we might need. It took us a while to get organized & get him on a gurney, put him on the Op Smiles portable monitor that fortunately had charged a few hours, got portable suction, an emergency box of all the meds we were using, other emergency supplies in case his breathing tube or IV came out, an oxygen tank & a variety of other equipment. By the time he was settled on the gurney it was probably midnite & we were ready to go….we got to the hallway & remember before I said the elevator was unsafe – while we debated whether to use it or not we were told it was not even working….that meant we needed to carry the patient on the gurney with all the equipment down 4 flights of stairs.  We moved slowly toward the stairs & down one flight at a time counting stairs for everyone because of course there are no lights in the stairs & the few flashlights we had gave little visibility. I felt like I could have been in that video of the nighttime rescue of the American girl soldier that was rescued & carried down some stairs in a foreign country. I was at the head with Glenn he was breathing for the child & I had the end of the gurney…it was a challenging process but we got to the ground level then out to the ambulance & loaded the patient & all the equipment & the 4 of us as a medical team – it was a tight fit, plus his parents in the front seat. Molly & 4 others followed us in a car. With all of our equipment not really secured including an oxygen tank we asked them to drive slow & safely with lights & siren.  It was only about a 10 min ride & en route we read the papers the hospital gave us as we left that said the little boy had a large brain tumor…that was new information to us..that no one seemed to know or share with us at the hospital & certainly impacted things. This other hospital did have an old CT Scan machine so Glenn contacted Molly et al to say we needed to go there first to understand what we were dealing with.

We arrived at the other hospital dark exterior & no one to meet us & slowly got out onto a very rocky road, were met by a doctor who said he didn’t know about the patient & when we said we wanted to go to CT scan just pointed out into the darkness – someone insisted that he show us where to go (basically they kidnapped him & he led us to the other bldg) &this was another 600-800 yard journey thru a parking lot over rocks & speed bumps, over curbs to another building that fortunately had a ramp up to it because otherwise all that was outside it was gravel.  The resident physician in the CT scan areas said he volunteered to help us but we needed an order & payment promise from the other hospital – it was beginning to feel like a weird movie. Finally that was settled & we got him on the scanner – he did have a very large posterior fossa tumor that blocked his 3^rd & 4^th ventricle & it didn’t seem the shunt device they put in toady was working in fact the bottom end in his abdomen may have punctured part of his stomach. What that meant was no matter what he had a very slim chance or survival. As Glenn & Annameike went to review the CT scan results I stayed in there & hand ventilated him. At that point I just wanted to give him the loving care any child deserved. I took my glove off my right hand as I used my left hand to breathe for him & just caressed his head & told him he wasn’t alone….all the time crying behind the CT machine.

We now needed to get him to the PICU on the 4^th floor of another bldg.. but the doctor (the intensivist I thought but it turns out it was a resident on call for the entire hospital?) told us we couldn’t take him up cause their ventilator didn’t work.  He also told us they didn’t do neurosurgery there – that only happened at the hospital we came from…but that hospital didn’t have an ICU….we were for a few moments in no mans land. Glenn told them I know you don’t think you can take this patient & he may very well code & die but none of us what that to happen here plus we were running out of oxygen in our tank so we basically said we were going to the PICU. The doctor left us at that point & we proceeded out on our own not 100% sure how to get there. We came out of this building & then went down a tiny alleyway full of old medical equipment on a rocky road – about this time Glenn said he felt like we were in a scene from American Sniper….it truly was surreal. We got to the elevator & 3 of us went in – we were told the buttons didn’t work well, sometimes it stopped on the floor & other times in between floors –but we really had no choice at that point. Everyone else walked up the stairs & fortunately when the door opened we were on the 4^th floor.

We rolled to the PICU, got a new oxygen tank but they would not let us in or assume care of the patient as they didn’t have a functional ventilator and weren't sure they were going to let him stay. It was again very surreal – they didn’t even come talk to us or ask about the patient. Out Op Smile Bio med tech Abreham who is truly gifted tried to fix the ventilator & at least figure out what was wrong & went back to the other hospital to get his tools to fix it…while we took care of the patient in the hallway. He had a high fever & was probably septic so we gave Tylenol & tried to cool him. I told the parents to hold his hand & asked Glenn if we could update them. Thru Aziza I told them we were  doing all  we could for him & brought him here for the scan & the breathing machine.  The mom was tearful & I just put my arm around her as she cried like I have done hundreds of times before with parents at CHOC – I might not be able to change their sons condition or outcome but I could care for them with compassion. Glenn also asked them some questions re. their understanding of their sons condition & tumor & how long he had been sick – it had been 5 months since he was diagnosed with the tumor & today was their turn for surgery & they thought the tumor was being removed & he would be "all better". There was nothing further from the truth. That again is something truly most people in the US & other countries don’t understand – in the states you have a brain tumor & within a few days have surgery…it made everything that had happened that night a little more understandable but no less heartbreaking.

Miraculously Abreham fixed the ventilator & we were able to move him into their unit & onto a bed got him settled, gave them our “report” and were ready to go…that was about 2:30 am – I was exhausted physically & emotionally – I had only eaten some fruit for breakfast and a protein bar at lunch –  I hadn’t had many fluids & had a huge headache & heartache – I stopped to hug the mom once more & then we left to load ourselves & our equipment back in the ambulance for a silent ride back – no one felt like talking. They took us back to the hotel & we offloaded all the Op Smile equipment there. I walked up to the hotel wondering if all of this just really happened….again I found myself wondering was it better that I was here? That we were all here? If we weren’t the child probably would have just died in the recovery room alone with an Ethiopian nurse…he was given the best care by some very skilled people in a very limited environment. Were we able to change the ultimate outcome – maybe not but he got a better chance than any other Ethiopian child, We couldn’t not intervene….we did get his parents there to be with him …these seemed like very small ‘wins” but they were all we had.

I dropped my bag of equipment & took the elevator to my room & my head was spinning as it always does after a situation like that again I thought - was it good that I was here?, that Glenn & Annameike & Aziza were here? Did we make a difference – is this part of a bigger plan or is this just life in a 3^rd world country & we witnessed it up close & personal?  I laid on my bed at 3:30 & fell asleep at some point & woke up at 9….the patient announcements were at 8 am this morning – I had no remembrance of that, today was the team day – that seemed insignificant, the mission hadn’t even started????  There were probably 35 team members who had minimal to no idea what went on last night or what we went thru – it seemed like a bad dream. I made my way to breakfast, told Molly there was no way I could go to team day at 10 but I did need to go & get a fresh start & didn’t want to sit around the hotel all day. I needed to shower, regroup & start this new day. Jeanne & Laney came to check on me – I told them my plan & that I would take a taxi to the team day…they asked if I knew the little boy had died at 4 am…I didn’t….

I mean I was the one to say he might die, I was there thru it all & saw all the signs but I just didn’t think that an hour after all or our heroic efforts & after we left he would be in heaven. I had a hard time wrapping my head around it all. Glenn said we would have a “debrief” but I don’t know when…

Often these missions teach me lessons that I know I can’t learn anywhere else & give me opportunities to meet & instantly love & use my training & talents to treat children & families I will never see again – today & this experience was no different. I am so grateful to now life is eternal that there is meaning & purpose in everything we just can’t always see it at the time it happens & we have to have faith & often learn the meaning much later. Perhaps I will understand this situation when I am further away from it..right now I need to start a new day….keep the prayers coming…they are felt

Day #3 - Part #1 Sat June 6th – One Day that felt like Two

Typical morning 6 am wake up, 6:30 breakfast, 6:45 mtg , 7:15 departure arrive at the hospital after 8. Unlike yesterday there were no patients waiting & we had no set up to do so for the first hour or so we just sat & visited. Leigh is here are “Safety & Security” & I was visiting with her  -WOW!!! She has a degree in marine & air engineering (yes she could design ships, submarines & aircraft), got a job after college with the State Dept, ended up designing the small submarine units for Military Special Ops teams & worked with Seal Team 6 extensively, all of this as a civilian. Her stories were amazing & a few years ago she & a few friends from Seal Team 6 started a safety & security business that many government & non govt corporations use & apparently the COO of Op Smile was on Seal Team 6 & has them consulting on mission safety. Truly there are people from all walks of life on these missions.

The 4 Missionaries that I talked to showed up at 9 am to help with cargo – 2 in their white shirts & ties & 2 in work clothes. They are in the Uganda Campala Mission which covers parts of Rwanda, parts of Uganda & all of Ethiopia - 3 countries. The majority of the missionaries are in Uganda & Rwanda where the church membership is large; in Uganda they are opening their 2^nd Stake (like a Diocese). Elder Thornton was the Zone Leader & he has been serving for 23 months & goes home to Kamas Utah July 5^th. His companion Elder Dramudri is from Ghana & had previously been in the Sierra Leone Mission & when it was closed due to Ebola was transferred to this mission & he had been companions with our good friend Cody Beckett so that was fun! Elder Burdette is from Oregon & has 8 months left & Elder Robinson was from Utah (I am blanking on the city) & has only been here 6 months. When the  Sierra Leone mission closed they had 24 missionaries in Ethiopia but now they only have 12. There are about 800 church members but based on where they live only about 250-300 attend church regularly in the 5 branches here.

I introduced them to Molly, she said cargo wasn’t coming until 9:30 so they helped get cases of water & then Jeanne an OR nurse who is also LDS & from SLC did a “moms interview” with them & is going to call their parents when we get back. I took some pictures to send their families. They were so fun to talk to. We had a patient scale & they all wanted to weigh themselves & were all a little bummed they had each lost between 10-15 lbs (of pure muscle of course according to them!). AT 9:30 we were told the cargo would be here at 11 so they helped with whatever was needed, at 11 they said cargo would be here at 1 so I gave them 500 Birr ($25) & told them to go get lunch & come back at 1 – they were excited & appreciative

We only screened about 30 patients but it really isn’t about the 3’s its about the people. Several of them were from a Sudanse refugee camp in Gambala which was about 750 km away & took them 2 days to get there. Their interpreter who brought them was a man name Bol – I talked to him & was humbled & inspired by his story. He wore a suit & glasses & walked with a cane. He had polio as a child in Sudan, as a teenager his family came here & he was in a refugee camp, at some point he was able to leave the camp & went back to Sudan where he went to University and got a degree in Social Services. Then I am not clear why but her was sent back to the refugee camp. As I understand it Refuge Camp life is very difficult but Bol despite all his own challenges & education & feeling like he did not belong in the camp was resilient & instead of being down or complacent he told me he decided to be a “social worker” in the camp & help “his people”. He especially watches over the women & children. I told him he inspired me & he said he was only trying to show Gods love to his people and that it was his honor to serve his people. He had coordinated the transportation of 6 people up to Addis & gotten some funding from organizations and from individuals but the travel expenses were more than they had allotted & he was trying to secure gas money funding this week in Addis  to “take his people home” (to the refugee camp) and they would all be fine without food for the 2 day trip. I couldn’t really process it all??? I spoke to our coordinator to see if I could offer help as I had resources given to me but I always need to check with Op Smile because if word got out among others it can cause a difficult situation. They said I could so later in the day I had the opportunity to pull Bol aside & tell him I had funding for fuel & food & gave that to him…he bowed before many times & thanked me – I told him it was from my wonderful friends & that people all over the world appreciate people like him.

The missionaries called because they were running late…but so was the cargo. When they got back they were all in work clothes & said they had gone & “treated themselves” & stuffed themselves with some good Pizza at Island Breeze restaurant with the - they were so happy. Cargo did finally arrive & they with some of the men tam members  unloaded about 75 boxes 7 carried them up to the 2^nd floor of the hospital which really was 3 floors up? They are going to come back on Friday & help us pack up. It is so great to see the way the Church is “worldwide” & the service of these young men.

We got back to the hotel about 3 pm & Pres. Biru was going to be here to meet us at 4:30 (but I was told by the missionaries no one here uses sur name so that all call him Hap Tu). I totally crashed asleep when I got back barely woke up at 4:15 – I hadn’t slept well last night I must have just been exhausted after my travel because last night the bed truly felt like a piece of plywood & I could not get comfortable – hence the unplanned nap!. Hap Tu was in the lobby at 4:30 & when I asked yesterday how I could help some church members here he said he would think about it & pray about it & we could talk more tomorrow. He brought Abanezer with him, a young man who is 19, working 3 jobs  & trying to save money  go on a mission. His parents are deceased & he & his younger sister live with their grandma. He wants to serve God to honor his parents but he also helps support the family. He was very soft spoke as many Ethiopians are & VERY HUMBLE…I KNEW 100% he was the person I should help for a couple that had given me some money before I left. Laney & Jeanne were there  & I got very emotional as I told him what a great young man he ws & that there were people in my ward at home who wanted to help him go on his mission by giving him the $$ to buy a suit if needed (depending on where he will go) or pants & shirts & ties & shoes. He was so so grateful & Pres Biru told him this was the answer to the boys many prayers & his faith about being able to serve. It was a powerful moment. Abanezer then left & Pres Biru took the 3 of us on a little tour of Addis up by the US embassy & shared some great info with us about the people of Ethiopia. He is currently employed by the church & has been for 8 years but says he soon needs to get back to his own business (he has a several rental car business which I understand is  a major industry here). He travels thru Ethhiopia, Uganda & Rwanda on church work & is the church liason with all branches of the government her & says the church quietly send millions of dollars of humanitarian aid annually to the countries of Africa & he oversees that. He drove us by the US embassy & took us to see Zina Winchet a woman he met who is blind & a widow with 2 daughters & created organization for other disabled women to assist them in learning skills to support themselves. She was recently assisted by a Catholic woman from Ireland who is here with her diplomat husband. After listening to all she does she truly is like the “Mother Teresa” of Ethiopia and she is the brightest most positive person – she does not see herself as disabled only blessed by Jesus to do his work. I was in awe of her. She has 3 rooms each with 2 beds so she can have 6 women at a time. She has a room of clothing & toiletries (much like good will) so they can have a “fresh start” when they come to her, she feeds them & cares for them & then teaches them skills to bring in money to support themselves & her 2 daughters were delightful.  She also has a Braille Typewriter which I had never seen & recorded our names. The women in her organization recently did a “fair” & sold nearly all they had but she showed us some of their bead work & we were able to make some purchases & donations. Her yard was full of about 100 old metal broken chairs that Pres. Biru said weren’t there last week & she told us – they were a donation & what God provides we accept. It was truly an amazing visit & I was so honored to meet her.

We had to be at the hospital at 6 pm for set up so Pres. Biru dropped us there. He is clearly a very busy man, a business, a wife & 2 children, and church work but he was so kind & gracious to make time for us today which was a treat for us before we start the mission.  

Setting up the Recovery Room was a challenge because the hospital was still doing their own surgeries but we did what we could & got organized. It seemed like any other set up – organized chaos there was a hospital patient in the recovery room with an Ethiopian nurse, we all noticed he seemed to have occasional breathing problems & the nurse would adjust the oxygen. I didn’t think much of it & did go look at the little boy a few times. By 8 pm we were pretty much done & thinking we would all leave in 30 min. I was just outside the room in the hallway…everything  changed about 5 min later when the child in the room stopped breathing & the Ethiopian nurses was unsure what to do. At that point Aziza one of the other Recovery Room Nurses stuck her head out of our room & called for help. I will post about that separately in case anyone who only wants to read “the good positive stuff” wants to skip over that post. All I will say her is I got back to the hotel at 2:45 am – it was a very long night.  

112 Patients seen on SCREENING DAY #1 6/5/15 Ethiopia #3

It has been a LONG but wonderful day. Some team members arrived last night & we were all together for the first time this morning. The drive to the hospital wasn’t that bad…when we got there we saw 3 very dilapidated bldgs. – I was actually afraid to ask which the hospital was!!! One was almost an abandoned bldg. & that is where we were doing screening. We had one large room & another smaller room – there are about 8 stations (pt photos & medical records, nursing & vitals, surgeons, anesthesia, pediatrician, dentist, lab, speech then gatekeeper)  & typically each station is in its own rom or area so clearly this was a challenge but Laney & I decided to take on the task & with the limited “furniture” we had (benches, chairs, a few tables etc) we created a very efficient & workable space. I blame Doug for making me watch the Property Brothers renovation show for this new found skill of space transformation! We even took 2 VERY rusted out poles & made an area with some privacy for the older girls who needed some privacy as the drs listened to their heart & lungs.

When we arrived there were already several people waiting plus the bus that was bringing the patients from the shelter so once we started we were busy. I was the gatekeeper with Aziza and was training her in that role but honestly since she spoke Ahmaric SHE did ALL the work!!!  I helped with the structure and kept all the records & data  but the process of talking to nearly all 112 patients was up to her!  Laney & Jeanne also helped taking patients where they needed to go after they left us. There are LOTS of patients with primary lips & palates (84 to be exact!) that haven’t been repaired. In this environment repairing both is too high risk so they will all get their lip repair now & if they are old enough will get their palate repair in 6 mos on the next mission.

Many of the people in this group were from the Somali refugee camps at the border of Somalia & Ethiopia – a 1500 KM or 3 day trip that is in no way easy or include ANY of the travel comfort we are used to.  We have to have separate Somali translators for them & while I have never understood it they can at times seem to be a little more demanding that the Ethiopians – I took it as a reflection of their challenging life & just gave them an extra measure of kindness but to be honest I really didn’t understand how the refugee camps work.   Jeanne shared with me her experiences with some work she has done there & I feel like I understand more that to survive in their challenging conditions of being isolated in no country that accepts you it really is survival of the fittest, as Aid workers come in you have to be bold to get what you need….my heart broke for them just a little more as I thought of this hardship and that in the end these are moms just like me trying to get their children the medical help they need in a very uncertain world. We also had several Ethiopians who traveled from the northern part of the country in Tigrey – also a 2 day trip & Jimma a 1 day trip.
It was a BUSY day I really didn’t stop except once to have a quick protein bar. The bathrooms were disgusting – basically a hole in the ground in a room so I managed to not drink so I didn’t have to use them after Laney came out & said she was gagging!!! MY plan is to overhydrate at night & not drink much during the day to avoid needing to go to the bathroom – it has worked in the past – I just had amnesia about Ethiopian “bathrooms” that have no running water – YUCK!

Tomorrow we will screen again – probably not as many people I would guess. We will also set up the OR’s & Recovery room & patient ward. Our Cargo had not cleared customs until late this afternoons that was a challenge but it will arrive tomorrow. I had been trying to reach the LDS church here since we are in a larger city & wasn’t having much luck until I was text some contact #’s & tonight the first one I called had no answer then that # called me back & it was a set of missionaries. I explained I was here & was hoping to help some church members here as well as the people I will meet in Op Smile. They gave me a better # for the District President here & I also asked them if they would like to come help unload cargo tomorrow – he gave me the phone # of the zone leader here so I called Elder Thornton of Kama Utah & chatted with hm for a long while & connected him with Molly our coordinator & there will be 6-8 missionaries at the hospital in the morning to help us unload all our cargo – such a blessing to our team that there ae here & willing to serve. I am also excited to see them & let their families know what great work they are doing here!!!  After that call I spoke with the District Pres. Biru & had a wonderful conversation with him. He knows a woman who is blind & she runs an organization for disabled women & they sell goods they make. He is going to take Jeanne & Laney & me there tomorrow night. He also knows a young man who could use some help & we may get to meet him, plus there are many needs within the shelter & our patients. I am grateful for these “side opportunities of service”. It can be overwhelming to see the immense need and be unsure as to how to help but I have found that helping people directly is best & as you lift them they go on to lift others.

It is almost midnight again & the wake up call will be 6 with a schedule like yesterday so I need to get to sleep. A few things I don’t want to forget….as I went to brush my teeth last night I forgot I needed to use bottled water until I had a mouthful of toothpaste – I take for granted clean running drinking water, the “hair” dryer in the hotel looks like the 1960’s version you see on TV with the big hose & bonnet & 2 setting neither of which are warm or stronger than the other – needless to say I air dried my hair, the drain in the shower is a good 3 inches & doesn’t have a drain cover over it…creeps me out that something could come out of it!, the only “diet coke” is Coca Cola Light in bottles & really is disgusting, there is no thermostat in the room & the air is musty , they have TV’s but no channels that work???. Despite all of that there isn’t anywhere else I can picture myself right now…..I am absolutely in the right place doing the right thing at the right time & that doesn’t happen every day in life so for that I am immensely grateful. I miss my family but social media, texting & even a face time audio has helped. I feel the love & support of so many & only hope that as I have a chance to extend your kindness & service to these sweet people you feel it too.

 Good Night!

Arrived in Ethiopia & Visit to the Shelter Thurs June 4th

*Note – this really serves as my journal so the forst parts are all about the travel & probably quite boring to others but the writing further down about the shelter is WONDERFUL!!!

I arrived safely in Addis Ababa Ethiopia. I have to say my travels weren’t as bad as I imagined them to be. Sweet Kristen took me to LAX & I got my bags checked but no seat assignment – which I have had for 3 months since my flights were ticketed. When someone from United was finally at the counter I told him this & showed him my confirmation & he told me “that is just a seat request not a confirmed seat”? & we only have middle seats left unless you want to pay for more leg space???  I may not be a weekly traveler but I am pretty sure that whenever I have “reserved a seat” it has been mine??? I took a deep breath, asked if you could possibly help me as I was starting 24 hours of travel, gave him my boarding pass with no seat  & sat back down. Unfortunately there was confusion re. the flight in general & it ended up being  an hour late in departing & changed gates 3 times so at some point I was just hoping the same man would be at whatever gate we left from with my boarding pass. I was pleasantly surprised when I went up at the final gate & he said here you have a window…when I boarded I found it was row 8 the 1^st row after first class & a bulkhead seat with lots of leg space so I was VERY happy & grateful to the many praying for my easy & safe travels! Once we left I was super tired & think I got about 4 hours of sleep. I was to have a 4 hour layover & that was decreased to 2 ½ with the LA delay but I was good with that, & had time to grab a Starbucks oatmeal & get to my gate. My flight to Addis had 3 other Op Smile team members on it Glenn one of the Anesthesiologists & a team leader who was in first class reclining in his bed & being served food on china (yes I was a little jealous)  plus Connie who was coming to do Medical Records & Karen a Pre/Post nurse I knew from Honduras. The plane was 100% full….REALLY who all was going to Ethiopia I thought? Then I realized that there were MANY families who are living in the USA & there were at least 50 kids under 6 with parents going to see relatives there. I was worried about the 16 hour flight for me but more worried how the little ones would manage!!!  I wanted to try to “get on Ethiopia time” since we would be arriving at 8 am Thurs so I planned to stay up for the 1^st 8 hours of the flight & then see how much I could sleep when it was “night”. Basically it was a 4 Movie flight…the 1^st Marigold Hotel, Edited American Sniper which I was excited to see, Selma & Big Hero 6 kept me busy. I did sleep for about 4 hours somewhere in then. When we arrived in Addis since this wasn’t my first adventure there I moved us all thru the Visa process, immigration, money exchange, luggage retrieval & customs – it was NOT a fast process & probably took us 2 or more hours.

We were met by Molly the Program Coordinator (who I adore & was with in Honduras) & then got to the hotel – I was actually impressed & it seemed pretty nice – as mission hotels go J There were about 8 of us from the team in the lobby checking in so we decided to all got spend an hour getting settled & then meet to go out in the city. We went to a shopping area but since I have been here twice before I wasn’t really doing much shopping. We also went to find what was to be a great bakery & coffee shop (that is Ethiopias biggest export) which eluded us for awhile – we went up & down the same street 4 times – felt a little like groundhog day & by then I was getting tired. I had forgotten about all fo the children on the street begging & adults as well, also the uneven streets with HUGE potholes & 6-12 inch variances in height & curbs.  I have gotten pretty “immune” to the people on the street & found it better to help in other ways & if they get too close to me I firmly say no. Connie wasn’t soo lucky & a few hours after we were out realized her phone had been pickpocketed out of her zipped fanny pack that she was wearing in front of her. There were 2 adults & 2 boys that bothered us the many times we were on that street & were trying to distract & get close & that must have been when it happened. I felt SOOOO bad for her & remembered how sad I was when my camera was stolen on my first trip here. It was a HUGE wake up call to everyone.  

We came back to “really unpack” & then were going to meet again at 5…I unpacked & somewhere in there fell asleep & woke up at 5:30. The beds are awful…it feels like you are sleeping on plywood but at that time it didn’t matter – hopefully I will still sleep okay all week. I went down to the lobby at 5:30ish & Molly was there & was going with the Pediatrician to the shelter as a few kids had fevers – I asked to go along so Maria an OR nurse from Sweden & I went with them. It is literally 6 blocks from the hotel in a large building in a car junkyard? The volunteers from Mekele came down to run the shelter here. As soon as I approached the shelter & then walked in & saw those precious children with their parents I got teary & knew this was EXACTLY where I was supposed to be.  There were already 96 children at the shelter each with typically one parent – a few with 2 so over 200 people there on thin 1” mats on a concrete floor. This was the first time I realized that in the shelters here the men & boys  are on one side & the woman with their child or baby & girls on the other. I went to the boys side first – they LOVED having their photo taken & then seeing it  -honestly the bigger smile comes as they see a picture of themselves. Then everyone wants a photo…there were quite a few older schoolage boys. The girls always steal my heart they are so cute & the Muslim girls with their head coverings are often stunningly beautiful. One little girl I REALLY THINK I knew from Mekele -  am going to have to look at old pisc  she took my had & walked with me – we took a pic together & I was instantly in love. While we were there is was close to sunset & many of the men & 1-2 women put out their Prayer mats: & all prayed – it was very inspiring to see them enact their faith so publicly.  Going to the shelter REALLY got me excited for the week & even all the hard work that is before us – many of these people in the shelter today were from Somalia & had traveled 1-3 days by car, bus or foot to be her just HOPEFUL that there was help for their children. It always chokes me u p when I want to complain about my 24 hour plan travel with movies & food etc.

We had a team meeting tonight just to go over the schedule – I can already tell this team is going to be wonderful  -lots of nice friendly people from 9 different countries united in the goal to change lives one smile at a time J

The hospital is about 45 min away by bus, we will be screening tomorrow & Sat & then know who is getting surgery on Sat. Of the nurses most have been on 3-5 missions so at 9 I come after the clinical coordinator in experience & she has probably 50 or more – so I am WAY behind her! I will once again be the gatekeeper…I both love & hate that job – love keeping all the patients & plans organized but hate it cause it can get a little crazy! But I will have another one of the PACU RN’s there training with me so together we will be great. The 2 other PACU RN’s I will work with are both “local” one from Kenya & the other is Ethiopian but has moved to Sweden recently. I think it will be a good team & the Pediatric Intensivist is great – she is from the UK.

A few other fun reminders just for me – Addis is a Malaria free zone so that is nice!, Op Smile has now added a Safety & Security person on some missions – really it is more disaster management & how we would respond if something went wrong – glad they are proactive but it is a reality reminder of the environment we are in. They also told us not to step into or use the elevator at the hospital as there have been injuries and a death??? I guess they just don’t close them down for that? So that gave me perspective on what to expect at the hospital. We are also at 8000 feet elevation – had no clue about that I thought I was a little winded as we walked cause I was tired!

Well I better get to bed – wake up call in 5 ½ hours are 6 am, breakfast at 6:30, meetng at 6:45 & bus leaves at 7. The good news is I have a decent shower with hot water – the challenge is it leaks all over the bathroom floor but that can be mopped up. In the time I have written this post the electricity has gone off & on 4 times so I think that will be the norm – but we do have wifi albeit slow & only when the electricity is on of course. So good night from Ethiopia!

PS Sorry I cant upload photos - I am technologically challenged. I tried to email them to myelf then upload but no luck. I am posting them on Instagram & Facebook though

I said YES to Ethiopia Round #3

Well I just finished packing & I leave for my 9th Medical Mission with Operation Smile tomorrow...as the title of the post suggests I am going to ETHIOPIA for the 3rd time!!!
I was invited to this mission about 8 months ago but it was scheduled in May the same week as Kelli's wedding so I declined & looked into some other missions including a few on the USNS Comfort & was pretty set to go to the Dominican Republic in August. In emailing the mission coordinator about something totally different 6 months ago I said - "Have a great mission in Ethiopia in May - wish I was going with you" & she immediately emailed back & said it's been changed to June do you want to go?
I didn't even hesitate & said YES....I decided Ethiopia is like childbirth - the process is challenging but the end results are AMAZING so you tend to forget the challenges until they come again!!! Clearly I remembered all the good when I said YES & forgot some of the details such as ...I really dislike the travel there is it about 24 hours on planes plus layovers & a 10 hour time difference. The food is really not anything I like to eat, the missions there in general are lots of hard work, long days, challenging environments and in the past the hotel was let's just say "rustic" - electricity off & on as well as water. But NONE of that was in my mind when I said YES.
Instead in my mind I saw these tremendously HUMBLE people who have such great needs & beautiful children whose lives will be forever changed by the surgery & care our team will give them. Moms & Dads who like parents here would do ANYTHING to get their child the help even travel for days on foot. People with deep faith & gratitude. Beautiful Children of God who need the care we offer and that is why I didn't hesitate & said YES!
A few facts about Ethiopia - it is the 2nd most populated nation in Africa. 16% of the people there live on less than $1 a day, most poor families share their sleeping area with livestock & children sleep on the mud floor. The average family size is 6 or 7 & they live in a 300 square feet  mud & thatch hutch. Even in the capital city where I will be this time Addis Ababa 55% of the population live in slums. YES I will go because the needs are great & my inconveniences while I am there are temporary.
I will seek for other opportunities to make a difference as well - in honor of some wonderful family & friends of mine who want to help people they have never met. Plus I have 20 dresses that were made for me to give away, and boys shorts & CHOC T-shirts & socks - I am so excited to arrive & meet the team & see some of my Ethiopian Op Smile friends I have made on past missions :)  
I still have a few more things to do - I will arrive in Addis Ababa on Thursday & will do my best to update my blog at night. Good thoughts & prayers not only for me but for the entire team & the people we will help are MUCH appreciated - there really is power in prayer & when I am having a challenge I draw on the strength of friends at home who I know love & support me. THANK YOU!